Southfork Group Home

LBN: Cdf Healthcare Of La, Llc
Southfork Group Home is an health care organization with primary practice located at 149 Afton Rd , Tallulah LA 71282-7455. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, which is considered as the primary health care specialty. Cdf Healthcare Of La, Llc can be contacted via phone (318) 574-0704, or through Debolt, Joe via phone (318) 878-5106.

Contact Information

Primary practice address
149 Afton Rd Tallulah LA 71282-7455
Phone: (318) 574-0704
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Debolt, Joe
Phone: (318) 878-5106

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X 978 Louisiana

Profile Details

NPI number 1205051711
LBN Legal business name Cdf Healthcare Of La, Llc
DBA Doing business as Southfork Group Home
Authorized official Debolt, Joe
Entity Organization
Organization subpart 1 No
Enumeration date Apr 17th, 2007
Last updated Jun 9th, 2010 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205051711 NPPES
Louisiana MEDICAID 1719668

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